TY - JOUR
T1 - A multicentre point prevalence survey of hospital antibiotic prescribing and quality indices in the Kurdistan regional government of Northern Iraq
T2 - the need for urgent action
AU - Kurdi, Amanj
AU - Hasan, Awat J.
AU - Baker, Kirmanj I.
AU - Seaton, R. Andrew
AU - Ramzi, Zhian S.
AU - Sneddon, Jacqueline
AU - Godman, Brian
N1 - Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - Background: Rationale antibiotic use is crucial to address antimicrobial resistance (AMR) threats. No study has been undertaken in the Kurdistan Regional Government (KRG) to document current antibiotic use/areas for improvement given the high AMR rates. Research design and methods: Point prevalence survey (PPS), using the Global PPS methodology, was conducted among the three major public hospitals in KRG/northern Iraq from September–December 2019. Prevalence and quality of antibiotic use were assessed using agreed indicators. Results: Prevalence of antibiotic use was high (93.7%; n = 192/205); third-generation cephalosporins were the most commonly prescribed antibiotics (52.6%; n = 140/266). Reasons for treatment were recorded for only 61.7% (n = 164/266) of antibiotics and high use (89.9%) of parenteral therapy was observed. All therapy was empirical, no stop/review dates were recorded, and no treatment guidelines were available. The majority of the prescribed antibiotics (62%; n = 165/266) were from the WHO Watch list. Conclusion: Prevalence of antibiotic use was high not only versus other hospitals in the region but globally, coupled with significant evidence of sub-optimal prescribing. Swift action is needed to improve future prescribing to reduce AMR. One or two areas should initially be targeted for quality improvement including development of local guidelines, documentation of antibiotic indications, and/or stop/review dates.
AB - Background: Rationale antibiotic use is crucial to address antimicrobial resistance (AMR) threats. No study has been undertaken in the Kurdistan Regional Government (KRG) to document current antibiotic use/areas for improvement given the high AMR rates. Research design and methods: Point prevalence survey (PPS), using the Global PPS methodology, was conducted among the three major public hospitals in KRG/northern Iraq from September–December 2019. Prevalence and quality of antibiotic use were assessed using agreed indicators. Results: Prevalence of antibiotic use was high (93.7%; n = 192/205); third-generation cephalosporins were the most commonly prescribed antibiotics (52.6%; n = 140/266). Reasons for treatment were recorded for only 61.7% (n = 164/266) of antibiotics and high use (89.9%) of parenteral therapy was observed. All therapy was empirical, no stop/review dates were recorded, and no treatment guidelines were available. The majority of the prescribed antibiotics (62%; n = 165/266) were from the WHO Watch list. Conclusion: Prevalence of antibiotic use was high not only versus other hospitals in the region but globally, coupled with significant evidence of sub-optimal prescribing. Swift action is needed to improve future prescribing to reduce AMR. One or two areas should initially be targeted for quality improvement including development of local guidelines, documentation of antibiotic indications, and/or stop/review dates.
KW - Antimicrobial resistance
KW - antibiotic utilization patterns
KW - iraq
KW - kurdistan regional government
KW - point prevalence survey
KW - quality improvement programs
UR - http://www.scopus.com/inward/record.url?scp=85094162338&partnerID=8YFLogxK
U2 - 10.1080/14787210.2021.1834852
DO - 10.1080/14787210.2021.1834852
M3 - Article
C2 - 33034234
AN - SCOPUS:85094162338
SN - 1478-7210
VL - 19
SP - 805
EP - 814
JO - Expert Review of Anti-Infective Therapy
JF - Expert Review of Anti-Infective Therapy
IS - 6
ER -